Maksymowych W P, Avina-Zubieta A, Luong M H, Russell A S
Department of Medicine, University of Alberta, Edmonton, Canada.
J Rheumatol. 1995 Apr;22(4):625-9.
Recent data implicates the cytokine, tumor necrosis factor alpha (TNF-alpha), in the pathophysiology of rheumatoid arthritis (RA). In vitro data suggest that pentoxifylline may possess anti-TNF-alpha properties. We have therefore carried out a prospective 3-month open evaluation of pentoxifylline in a group of adult patients with RA refractory to conventional disease remittive therapies.
Nineteen patients with RA were included and clinical assessments were performed according to the World Health Organization/International League of Associations for Rheumatology (WHO/ILAR) criteria at baseline, and one and 3 months after the initiation of therapy. Laboratory assessments included a complete blood count, erythrocyte sedimentation rate (ESR), and whole blood assays of TNF-alpha production. TNF-alpha was assayed using ELISA and semiquantitative polymerase chain reaction methodologies.
A significant diminution in number of tender and swollen joints as well as the ESR was noted after 3 months (p < 0.05) although no consistent effects on TNF-alpha production were observed. Furthermore, whole blood assays of TNF-alpha production shortly after initiation of pentoxifylline therapy were not predictive of the clinical response to this agent.
Although pentoxifylline may possess therapeutic properties in RA, any beneficial effects appear to be unrelated to changes in TNF-alpha generation in whole blood assays.
近期数据表明，细胞因子肿瘤坏死因子α（TNF-α）与类风湿关节炎（RA）的病理生理学有关。体外数据显示，己酮可可碱可能具有抗TNF-α特性。因此，我们对一组对传统疾病缓解疗法无效的成年RA患者进行了为期3个月的己酮可可碱前瞻性开放评估。
纳入19例RA患者，在基线时以及治疗开始后1个月和3个月，根据世界卫生组织/国际风湿病联盟（WHO/ILAR）标准进行临床评估。实验室评估包括全血细胞计数、红细胞沉降率（ESR）以及TNF-α产生的全血检测。使用酶联免疫吸附测定（ELISA）和半定量聚合酶链反应方法检测TNF-α。
3个月后，压痛和肿胀关节数量以及ESR显著减少（p<0.05），尽管未观察到对TNF-α产生的一致影响。此外，己酮可可碱治疗开始后不久的TNF-α产生全血检测不能预测该药物的临床反应。
尽管己酮可可碱在RA中可能具有治疗特性，但任何有益作用似乎与全血检测中TNF-α生成的变化无关。
